Health Insurance

crdle, first ask your Rav the halachic ramifications of working off the books and start reporting your income to the IRS.

Do you qualify for Healthy NY?

By “HDHP with HSA” Squak means: High Deductible Health Plan with a Health Savings Account.

How likely are you to have $5K of medical expenses (of the sort insurance pays) in a year? Remember that in case of a major disaster you would be unemployed and become medicaid eligible (and if you or a spouse might have a baby, there are special standards for medicaid maternity). Do you have substantial assets or are you “judgement proof” — meaning that if worse came to worst, you could file for bankruptcy if you had horrific medical bills.

If your typical medical costs are a few doctors outpatient visits, and some generic antibiotics you are will lost money by buying insurance at the rate of $5000/year.

Health insurance is a “bet” with the insurance company. You are betting you will be sick and injured and run up $5000 of medical bills, and they are betting you won’t (meaning they make a profit on the bet).

Whoa. Charlie & SJS- it is possible that her employer pays off the books (which is his own problem, not hers) and she in turn reports her income fully to the IRS. I believe there is a way to do this without getting the employer in trouble.

I think this may be what the OP does, since she says that she does not qualify for government sponsored health plans.

crdle: I think you should move to Canada where we have universal coverage. Most of us still carry some private insurance to cover things that are not covered by the government program. In the province that I live in we pay nothing for our government coverage, but some provinces do charge a monthly premium but it is very low by American standards. What I cannot figure out is that, to date, nobody has been able to come up with a plan that combines the best of the Canadian system with the best of the American – yet they have figured out how to put man on the moon. You live in the world’s wealthiest country with the best available medical care in the world, yet so many of your citizens have no coverage. It is a shandah.

Failure to pay your taxes is a felony. If the IRS catches up to you they can put you in jail for that. If your boss is paying you off the books find a new job that pays you on the books! And file tax returns for the years that you didn’t! Really if you approach the IRS they will work with you. If they find you they will put you in jail!

Here is the thing about heath insurance, on average you will pay in more than you get out. However if things go really badly and need major care then you could find yourself with $200,000 in debt!

To:charliehall._Cheating on taxes is asur_ really?I thought, impose crazy taxes on people- asur and unconstitutional(At least according Rush Limbaugh)

charliehall.

For the first $5000 of expenses (will cover anything less than major surgery) being uninsured makes a profit for the guy. Note the person didn’t mention a preexisting condition – normal people don’t run up $5K of medical bills. Even a broken bone or a trip to the emergency room won’t result in being out enough to make insurance cost efficient.

A serious “surprise” will probably result in the person becoming unemployed (remember, if he/she is paid off the books, they have little job security and no sick pay, and probably not a great deal of prospects of staying employed – leading to medicaid eligibility.

Hospitals have to take people in an emergency – and if they argue about the money you can threaten to file chapter 7.

If the person is actually likely to need insurance, and has assets, and has a real job- then they need insurance. But then, they wouldn’t be asking.

homell

please don’t use 2 S together

makes me sick even if i know what u meant, sorry

minyan gal

the shandah is the level of care, Canada gives.

I’ve spoken to Dr’s and they say it’s the worst!

u shouldn’t know from it, but by real medical issues, they have a long wait time (months for a cat scan, yes months)

and they prefer ppl dying it’s cheaper

squeak,

If she is an employee and not a contractor it is both her problem and the employer’s problem even if she does report all of her income because she can’t file a Schedule C. And there is no way for the employer not to get into trouble. The IRS considers this to be one of the biggest tax scams going.

homell,

I follow the torah as elucidated by Chazal and Rishonim, not by Rush Limbaugh. (And I bet he pays all his taxes!)

akuperma,

You don’t understand the nature of insurance. It isn’t an investment, or a gamble, it is about avoiding risk. And the worst risk one can make is with ones health.

crdle,

If you are in fact self-employed why did you say you are “off the books”? That is the term that is universally used to mean that one is hiding their income illegally.

aposhitermaidel,

The US system is clearly worse than Canada as measured by objective health outcomes, and it costs far more. And the primary reason for recent premium increases is not Obamacare (which doesn’t take effect until 2014) but the fact that insurers use earnings from investing their premiums to defray the cost of claims. And because of the economic collapse that Obama had nothing to do with, they have lost tons of money on their investments, particularly in real estate.

chesedname,

My wife is a physician and she has also talked with Canadian doctors. Things are so much better there that we seriously considered trying to emigrate. Doctors never have an HMO telling them what to do. Doctors never have to worry about getting paid. Doctors send ONE bill to the provincial government, rather than dozens of bills to as many health insurers, and the government pays the bill the first time rather than arguing. And had she gone to medical school in Canada she would have a lot less debt.

To :charliehall_ Dino de malchuso -Dino, its not so easy understand in our time, in this country.I’m sure in some circumstances(If Health insurance vital to your life), you can get getter to withhold(do not show) some of your income.

OK. Popa’s turn.

I love talking about health insurance.

Health insurance is a problem that will never go away unless we change the premises.

Technology is improving in all fields at a rapid pace. In most fields, we don’t invest in it, and don’t use what could be available, because it costs too much.

In medicine, we use all the most sophisticated advances, and invest heavily in making new ones. This is not surprising; we will pay everything we have to be cured when we are sick. Therefore, we will continue to invent new, necessarily more expensive, procedures and machines, and all pay to use them. We will only stop when we run out of available credit and assets.

So, is there no way out? Health care costs cannot go down, they can only go up. If a new machine is invented, we will want to use it. It will cost more.

As long as we insist that everyone must have access to the highest quality health care, costs will always go up.

There are two ways out.

A. We can prohibit new research. In five years, todays technology will be cheap, and health care will be cheap.

B. We can supply a fixed amount of care, and ration it based on need, not based on money. It will be illegal to pay for health care. Then, we only supply the amount that society can afford. (This is what Canada and Europe do. Yes, it is.)

If neither of those options is palatable, we need to rethink our assumption that everyone should get highest quality health care. Maybe it is ok for society to allow everyone to get the level they can afford. We can allow companies to sell insurance policies which cover 1995 technology only. Or, foreign educated doctors only. Hey, Japanese in 1995 weren’t so terribly neglected.

You can get a heter for abortion but not tax evasion? That’s nuts. If you don’t have bread on the table, but have an IRS bill from years ago, you can’t get a heter?

Or – we can have market rates apply to health care – like they apply to everything else. Because in today’s insurance driven system we are totally out of the loop in terms of cost. For example – when Lasik eye surgery first came out – the costs were about $5000 an eye. This treatment was not covered by insurance -so guess what – once the costs were in the hands of the people – the price went down – because nobody was going to pay so much money. The problem with our current system is that because we have insurance we don’t shop around for the most economic price – we don’t care if our insurance company is billed $3000 for an MRI. If we only had catastrophic insurance – and everybody would be paying for routine tests and appts ourselves – the prices would go down. One more factor is the huge malpractice premiums that US doctors pay to protect themselves against frivolous lawsuits. I definitely agree that there should be a financial penalty if a doctor makes a careless mistake (like taking out the wrong kidney) but today everybody is out to make a mountain out of a molehill and the doctors have to protect themselves. Those costs are passed down to us. Until we have Tort Reform – prices will not go down.

Google is your friend

I guess I’m your friend too, just this once 🙂

This is what Wikipedia has to say:

A health savings account (HSA), is a tax-advantaged medical savings account available to taxpayers in the United States who are enrolled in a High Deductible Health Plan (HDHP). The funds contributed to the account are not subject to federal income tax at the time of deposit. Unlike a flexible spending account (FSA), funds roll over and accumulate year to year if not spent. HSAs are owned by the individual, which differentiates them from the company-owned Health Reimbursement Arrangement (HRA) that is an alternate tax-deductible source of funds paired with HDHPs. HSA funds may currently be used to pay for qualified medical expenses at any time without federal tax liability or penalty. However, beginning in early 2011 OTC (over the counter) medications cannot be paid with HSA dollars (Sec. 9003 of H.R. 3590). Withdrawals for non-medical expenses are treated very similarly to those in an IRA in that they may provide tax advantages if taken after retirement age, and they incur penalties if taken earlier. These accounts are a component of consumer driven health care.

Proponents of HSAs believe that they are an important reform that will help reduce the growth of health care costs and increase the efficiency of the health care system. According to proponents, HSAs encourage saving for future health care expenses, allow the patient to receive needed care without a gate keeper to determine what benefits are allowed and make consumers more responsible for their own health care choices through the required High-Deductible Health Plan.

Opponents of HSAs say they worsen, rather than improve, the U.S. health system’s problems because people who are healthy will leave insurance plans while people who have health problems will avoid HSAs. There is also debate about consumer satisfaction with these plans. Some opponents believe medical expenses should be tax deductible for all individuals, not only those who have a savings plan.

You can also use any HSA savings left at retirement age for non-medical purposes, without tax implication.

“Oh and I just got myself a quote with Empire for $312. I still think thats nuts, since b”h i go to the doctor maybe once a year, i just feel like it wuold be such a waste of money to pour that down the drain each month! “

That offer might be worth grabbing. Empire is a good insurance company with a large network of providers. Should you get seriously ill or have an accident, you will be very glad you did. Remember that insurance is to guard against the unexpected, not to provide the expected.

“I’m sure in some circumstances(If Health insurance vital to your life), you can get getter to withhold(do not show) some of your income. “

I don’t believe you. Please cite a living posek who agrees.

“we can have market rates apply to health care “

We do! There are thousands of health insurers and there is a tremendous amount of competition. The problem is that health care is very expensive!!!

“High Deductible Health Plan “

This is not a bad idea even if you don’t have a Health Savings Account, as long as you don’t use it as an excuse to skip your preventive care and appointments. When you have going five years without ever filing a claim, bless your Creator for giving you such good health. Remember that insurance is to cover the *un*expected, not the expected.